Increased usage of CT scans in hospital emergency departments (EDs) has led to increased detection of incidental radiologic findings. Without follow-up, these findings can lead to delayed care. In response, the team at Vanderbilt Ingram Cancer Center developed a sustainable, automated system using the electronic health record (EHR) to prompt Oncology Nurse Navigators (ONNs) when a CT scan in the ED at Vanderbilt University Medical Center (VUMC) produced an incidental finding. This program resulted in more than 3,000 patients being flagged for follow-up and the team navigating 850 patients, all within two years of going live.
Vanderbilt University Medical Center and Vanderbilt-Ingram Cancer Center in Nashville, Tenn., recognized that their current push model of care and referral processes for ED patients with incidental findings had significant opportunities for improvement. With the opportunity to redesign our processes, we assembled a project team to evaluate the current and ideal state for assisting ED patients with incidental findings. This team included VanderbiltIngram Cancer Center’s associate nursing officer, chief surgical officer, nurse navigators, a project manager, and a business analyst, as well as ED stakeholders, such as the executive medical director, case managers, and a social worker.
